多西他赛致外渗性皮肤损伤80例治疗方法及疗效分析

Treatment and efficacy analysis of 80 cases of extravasation skin injury caused by docetaxel

目的探讨多西他赛致外渗性皮肤损伤的治疗方法。方法 80例经多西他赛治疗乳腺癌后出现外渗性皮肤损伤患者随机分为A、B、C、D组,每组20例。A组给予透明质酸酶皮下注射,B组给予地塞米松磷酸钠注射液皮下注射,C组给予注射透明质酸酶及地塞米松混合液,D组于皮损表面外涂多磺酸黏多糖。观察各组的治疗效果及治疗后14 d内皮肤愈合率及愈合时间。结果治疗后各组皮肤损伤面积均随治疗时间延长而呈逐渐下降趋势,其中C组下降最快,其次为A组、B组,D组下降最慢。治疗后3、6、9、12 d各组皮肤损伤面积组间比较有统计学差异(P<0.01)。治疗后14 d,各组愈合率有统计学差异(P<0.01),其中C组最高为100%,其次为A组(70.0%)、B组(60.0%),D组最低(50.0%)。各组愈合时间显著不同(P<0.01),其中C组最短,其次为A组、B组,D组愈合时间最长。结论透明质酸酶、地塞米松局部注射以及多磺酸粘多糖外涂均是治疗多西他赛致外渗性皮肤损伤的有效方法,而透明质酸酶与地塞米松局部注射联用疗效最佳。

Objective To explore the treatment of extravasation skin injury caused by docetaxel, Methods A total of 80 patients with extravasation skin injury after the treatment of breast cancer with docetaxel were selected and randomly divided into groups A, B, C and D （n=20, respectively）. Group A was injected with hyaluronidase subcutaneously, group B with dexamethasone sodium phosphate injection subcutaneously, and group C with the mixture of hyaluronidase and dexamethasone; the surface of skin injury in group D was applied with MPS. The efficacy and skin healing rate and healing time in the four groups within 14 days after the treatment were observed. Rrsults The areas of skin injury in the four groups decreased with the extension of the time oftreatment, and the area in group C decreased the fastest, fallowed by groups A and B, and that in group D decreased the slowest. The areas of skin injury in the four groups showed statistical difference on the 3rd, 6th, 9th, and 12th day after the treatment （P 〈 0.01）. On the 14th day after the treatment, the healing rate in the four groups was obviously different （P 〈 0.01） and is the highest in group C （100%）, followed by that in group A （70.0%）, group B （60.0%）, and group D （50.0%）. The healing time in the four groups was also significantly different （P 〈 0.01） and the shortest in group C, followed by that in groups A and B. The healing time in group D was the longest. Conclusion Local injection of hyaluronidase and dexamethasone and external application of MPS are effective on the treatment of extravasation skin injury caused by docetaxel, while the combination of hyaluronidase and dexamethasone has the best effects.